Myopia Prevention and Control

Treatments: Discussion

Myopia Treatment Options:

There have been many different treatments for preventing myopia over the years. A typical story is that the ancient Chinese slept with small sandbags on their eyelids to stop myopia, but I have never seen anyone who can cite an original reference to that idea. In any event, the goal of preventing or slowing down myopia is very current.

Myopia control studies vary widely in quality on a scale from anecdotal testimonials such as "I tried it and it worked" (which doesn't even make the grade as a poor study) to a large scale double masked randomized controlled clinical trial. Individual studies can often be criticized in specific areas such as poor choice of control subjects or too high a loss of patients to follow-up, but the preponderance of evidence from various studies tend to point in the same direction.

Myopia is a complicated disease that appears to have a genetic component that is triggered by environmental influences. That means different people will respond differently to the same situations. Many different studies have been done over the years and a cohesive story is beginning to emerge. You can read about it on other areas of this site. For now, let's examine the treatment options without trying to describe the background of each and why they may or may not work. Ultimately the goal is to decide on a course of action for the myopic, or soon to be myopic, person to follow. Some treatments have more drawbacks than others which may influence which is the best choice for an individual person.

Myopia Treatment: What Works?

Here's a quick summary of common treatment options along with their reported myopia prevention rates. High percentages mean the myopia is slowed the most. Read about various treatments in the different sections on the web site. Ranges are given for various reasons that can be found in the individual discussions and references. Question marks are for inconclusive data due to small numbers of people studied or limited journal references (bifocal contact lenses) or data not reported directly as myopic progression (outdoor time).

What slows myopia the most?
(with availability)

Atropine (60%-87 %) - many doctors are not aware of the research on low-dose atropine and reject atropine based on the side effects of the normally available 1% strength.

As you can see, there are not many options that actually reduce the progression to very low amounts. The medication atropine generally wasn't used in the United States due to its side effects but research on low dosage therapy shows clinically significant slowing of progression; Ortho-K and soft multifocal soft lenses both slow myopia about the same in different studies, varying from at least 40% to much higher in some studies. Lack of outdoor time continues to be a risk factor for myopic progression, so outdoor time is good.

The rest of the options are essentially relegated to situations with limited expectations. You can read about them in the menu selections. None of these additional methods work as well as simply spending more time outdoors. Read the Action Plan menu items to determine your best course of action.